Concurrent intra-arterial chemotherapy and radiotherapy for advanced laryngeal cancer.

Abstract

OBJECTIVES:

An intra-arterial chemoradiotherapy regimen (RADPLAT) provides remarkable local control for head and neck cancer. This study evaluates the efficacy of a reduced RADPLAT protocol in patients who are candidates for total laryngectomy.

METHODS:

Forty-three patients with advanced laryngeal cancer were treated with 2 courses of intra-arterial cisplatin infusion (100 mg per body) during 40-Gy irradiation. The patients who showed a greatly diminished tumor received sequential irradiation. The patients with obvious residual disease received chemotherapy during the sequential irradiation. Poor responders, with less than 50% tumor reduction, underwent total laryngectomy.

RESULTS:

Forty-two patients completed the protocol. All surviving patients were followed for at least 3 years. Thirty-four patients were alive (80% of the supraglottic cases and 87.5% of the glottic cases). Local control was achieved in 27 patients (67.5% of the 11 glottic cases and 64.0% of the supraglottic cases). The glottic cohort showed better progression-free survival rates than did the supraglottic cohort (68.8% and 45.0%, respectively; p = 0.019). There were 2 cases of grade 3 neutropenia and 3 cases of grade 3 mucositis. No patients required tube feeding. One patient required tracheostomy 3 months after the completion of the treatment protocol.

CONCLUSIONS:

Concurrent chemoradiotherapy with a reduced dose of intra-arterial cisplatin is feasible for patients with advanced glottic cancer.

• Authors: Tomokazu Yoshizaki, Satoru Kondo, Naohiro Wakisaka, Shigeyuki Murono, Noriko Kitagawa, Akira Tsuji, Masashi Nakashima, Jun-ichiro Sanada, Osamu Matsui
• Journal: The Annals of otology, rhinology, and laryngology (Ann Otol Rhinol Laryngol) Vol. 118 Issue 3 Pg. 172-8 (Mar 2009) ISSN: 0003-4894 [Print] United States
• PMID: 19374147 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Antineoplastic Agents
• Cisplatin

Topics

• Antineoplastic Agents (administration & dosage)
• Carcinoma, Squamous Cell (mortality, pathology, therapy)
• Cisplatin (administration & dosage)
• Cohort Studies
• Disease-Free Survival
• Dose Fractionation, Radiation
• Female
• Humans
• Infusions, Intra-Arterial
• Laryngeal Neoplasms (mortality, pathology, therapy)
• Male
• Middle Aged
• Radiotherapy, Adjuvant
• Survival Rate
• Treatment Outcome